Impact of Pharmaceutical Care on the clinical and healthcare parameters of individuals with type 2 Diabetes mellitus in primary care within Brazilian Public Health System
DOI:
https://doi.org/10.30968/jhphs.2025.163.1341Abstract
Objective: To evaluate the impact of Pharmaceutical Care (PC) on the control of clinical and healthcare parameters in patients with type 2 diabetes mellitus (T2DM) treated in Primary Care within the Brazilian Unified Health System (SUS) in the municipality of Curitiba, Paraná. Methods: A quasi-experimental before-and-after study was conducted, including patients diagnosed with T2DM, aged 18 years or older, who attended at least four pharmaceutical consultations at Curitiba Health Units between April 2014 and November 2018. Data were extracted from the E-Saúde electronic system and statistically analyzed using SPSS software. Healthcare outcomes such as the frequency of consultations and hospitalizations were assessed, along with clinical parameters including glycated hemoglobin, fasting blood glucose, and lipid profiles. Results: A total of 93 patients were included in the study, the majority being elderly and female. Pharmacotherapeutic follow-up lasted an average of 16 months, and patients attended approximately eight pharmaceutical consultations. During the intervention period, there was a significant increase in the number of medical and nursing consultations, as well as improvements in clinical parameters, such as a reduction of 40 mg/dL (p≤0.005) in fasting blood glucose in the PC Period compared to the Pre-PC Period. Glycated hemoglobin decreased by 0.7% (p=0.039) in the PC Period versus the Pre-PC Period, and by 1.56% (p=0.026) in the Post-PC Period versus the PC Period. No significant difference was observed in mean total cholesterol during the PC and Post-PC periods; however, reductions were noted among patients who initially presented with higher levels. Conclusion: PC represents a relevant strategy in the management of T2DM in Primary Care within the SUS. In addition to contributing to glycemic and lipid profile control, its implementation demonstrated potential to strengthen care coordination, fostering integrated collaboration among different healthcare professionals. These findings highlight the importance of multiprofessional collaboration and continuous patient counseling, both of which are essential for preventing T2DM complications and ensuring sustained adherence to therapeutic plans.
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References
Organização Pan-Americana da Saúde A atenção à saúde coordenada pela APS: construindo as redes de atenção no SUS: contribuições para o debate. Brasília: Organização Pan-Americana da Saúde;2011.
Gomes MMF, Esteves MP, Barbosa DBA, et al. Estudo Técnico no 23/2013; Projeções populacionais para o Brasil (2000-2060) e estimativas da população para grandes regiões (2000-2030): síntese de resultados de publicação do IBGE. Brasília: MDS;2013.
Malta DC, Merhy EE. The path of the line of care from the perspective of nontransmissible chronic diseases. Interface - Comunic, Saude, Educ. 2010;14(34):593-605. doi:10.1590/S1414-32832010005000010.
Cavalcante WT, Filgueiras MF, Olanda DES, et al. Gestão do cuidado em pessoas com doenças crônicas. Braz J Dev. 2023;9(5):16345-16354. doi:10.34117/bjdv9n5-123.
Hossain MJ, Al-Mamun M, Islam MR. Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Sci Rep. 2024;7(3):e2004. doi: 10.1002/hsr2.2004.
Muzy J, Campos MR, Emmerick I, et al. Prevalência de diabetes mellitus e suas complicações e caracterização das lacunas na atenção à saúde a partir da triangulação de pesquisas. Cad Saude Publica. 2021;37(5):e00076120. doi:10.1590/0102-311X00076120.
GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2023;402(10397):203-234. doi:10.1016/S0140-6736(23)01301-6.
Bahia LR, Araujo DV, Schaan BD, et al. The costs of type 2 diabetes mellitus outpatient care in the Brazilian public health system. Value Health. 2011;14(5 Suppl 1):S137-S140. doi:10.1016/j.jval.2011.05.009.
Młynarska E, Czarnik W, Dzieża N, et al. Type 2 Diabetes Mellitus: New Pathogenetic Mechanisms, Treatment and the Most Important Complications. Int J Mol Sci. 2025;26(3):1094. doi:10.3390/ijms26031094.
Aguiar PM, da Silva CHP, Chiann C, et al. Pharmacist-physician collaborative care model for patients with uncontrolled type 2 diabetes in Brazil: results from a randomized controlled trial. J Eval Clin Pract. 2018;24(1):22-30. doi:10.1111/jep.12606.
Alhabib S, Aldraimly M, Alfarhan A. An evolving role of clinical pharmacists in managing diabetes: Evidence from the literature. Saudi Pharm J. 2016;24(4):441-446. doi:10.1016/j.jsps.2014.07.008.
Pereira LRL, Freitas ODA. A evolução da Atenção Farmacêutica e a perspectiva para o Brasil. Rev Bras Cienc Farm. 2008;44(4):601-12, 2008. doi:10.1590/S1516-93322008000400006.
Zubioli A, Silva MARCP, Tasca RS, et al. Pharmaceutical consultation as a tool to improve health outcomes for patients with type 2 diabetes. Braz J Pharm Sci. 2013; 49(1):85-94. doi:10.1590/S1984-82502013000100010.
Pereira LB, Guidoni CM, Borges APS, et al. Evaluation of the effectiveness of pharmacotherapy follow-up in long-term control of diabetes mellitus type 2. Clin Biomed Res. 2018; 38(3):237-244. doi:10.22491/2357-9730.81089.
Bakhsh HT. Impact of Pharmacist Interventions on Health Outcomes of Patients with Type 2 Diabetes Mellitus in the Middle East: A Systematic Review. Integr Pharm Res Pract. 2025;14:85-98. doi: 10.2147/IPRP.S515197.
Barberato LC, Scherer MDA, Lacourt RMC. O farmacêutico na atenção primária no Brasil: uma inserção em construção. Cien Saúde Colet. 2019; 24(10):3717-3726. doi:10.1590/1413-812320182410.30772017.
Zucchi P, Ferraz M. Economia e gestão em saúde – Avaliação econômica em saúde. Barueri: Manole;2010.
Strand LM, Cipolle RJ, Morley PC, et al. The impact of pharmaceutical care practice on the practitioner and the patient in the ambulatory practice setting: twenty-five years of experience. Curr Pharm Des. 2004;10(31):3987-4001. doi:10.2174/1381612043382576.
Brasil. Ministério da Saúde. Secretaria de Atenção Primária à Saúde. Departamento de Promoção da Saúde. Cuidado Farmacêutico na Atenção Básica: aplicação do método clínico. Brasília: Ministério da Saúde;2020.
Ministério da Saúde. Gestão do Cuidado Farmacêutico na Atenção Básica. Brasília: Ministério da Saúde;2019.
Ministério da Saúde. Serviços farmacêuticos na atenção básica à saúde. Brasília: Ministério da Saúde;2014.
Malta D, Silva M, Albuquerque G, et al. Política Nacional de Promoção da Saúde, descrição da implementação do eixo atividade física e práticas corporais, 2006 a 2014. Revista Brasileira de Atividade Física & Saúde. 2014; 19(3):286. doi: 10.12820/rbafs.v.19n3p286.
Sociedade Brasileira de Diabetes. Diretrizes da Sociedade Brasileira de Diabetes 2023/.2024. São Paulo: SBD;2023.
Faludi AA, Izar MCO, Saraiva JFK, et al. Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017. Arq Bras Cardiol. 2017;109(2 Supl 1):1-76. doi:10.5935/abc.20170121
Fávero PF, Belfiore P. Manual de Análise de Dados – Estatística e Machine Learning com Excel, SPSS, Stata, R e Python. Rio de Janeiro: LTC; 2024.
Ministério da Saúde. Vigitel Brasil 2023: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2023. Brasília: Ministério da Saúde;2023.
Coutureau C, Slimano F, Mongaret C, et al. Impact of Pharmacists-Led Interventions in Primary Care for Adults with Type 2 Diabetes on HbA1c Levels: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(6):3156. doi:10.3390/ijerph19063156.
Conselho Nacional de Secretarias Municipais de Saúde. Instrumento de referência dos serviços farmacêuticos na Atenção Básica. Brasília: CONASEMS;2023.
Malerbi F, Andrade R, Morales P, et al. Manejo da retinopatia diabética. São Paulo: Sociedade Brasileira de Diabetes; 2023. doi: 10.29327/557753.2022-17.
Seyffarth AS, Lima LP, Leite MC. Abordagem nutricional em diabetes mellitus. Brasília: Ministério da Saúde;2000.
Borges APS. Avaliação do impacto clínico e da viabilidade econômica da implantação de um modelo de atenção farmacêutica em uma UBDS de Ribeirão Preto-SP. Faculdade de Ciências Farmacêuticas de Ribeirão Preto: Ribeirão Preto;2008. doi:10.11606/D.60.2008.tde-03122008-171950.
Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e563-e595. doi:10.1161/CIR.0000000000000677.
Cipolle RJ, Strand LM, Morley PC. Pharmaceutical Care Practice: the patient-centered approach to medication management. New York: McGraw-Hill; 2012.
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